Probiyotiklerin periodontal tedavideki yeri

Sağlığa faydalı canlı mikroorganizmalar olarak ifade edilen probiyotikler, uzun yıllardır gastrointestinal sistem hastalıklarının tedavisinde başarı ile kullanılmakta ve immün sistemi destekleme ve patojen mikroorganizmaları baskılama etkilerine dayanılarak son yıllarda periodontal sağlık ve tedavi üzerindeki etkinliği araştırmacılara konu olmaktadır. Bu derlemede probiyotiklerin periodontal tedavideki yeri ve etkinliği değerlendirilmiştir. Periodontoloji alanında probiyotikler ile ilgili yapılan çalışmalar henüz başlangıç aşamasındadır. Bununla birlikte periodontal sağlığı geliştirme ve periodontal hastalıkların tedavisi alanlarında cesaret verici sonuçlar elde edilmiş ve bu sonuçlarla daha detaylı ve uzun dönem çalışmaların yapılması ve tedavi protokolleri içine yerleşebilmesi için önemli bir temel oluşturulmuştur.

Probiotics in periodontal therapy

Probiotics, defined as live microorganisms which are beneficial for health, are being used in the treatment of gastrointestinal disorders with success for many years. In recent years, researchers have sparked interest in the efficiency of the probiotics in periodontal health and treatment, based on their effects to support the immune system and suppress pathogenic microorganisms. The role and activity of probiotics in periodontal therapy are evaluated in this review. Probiotic research in periodontology is still in its start up phase. Nevertheless, pioneering results in periodontal health and periodontal therapy are encouraging, and with these data, a certain basis for the generation of further exhaustive and long-term studies are warranted.

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  • Offenbacher S. Periodontal diseases: pathogenesis. Ann Periodontol.
  • Rhemrev GE, Timmerman MF, Veldkamp I, Van Winkelhoff AJ, Van der Velden U. Immediate effect of instrumentation on the subgingival microflora in deep inflamed pockets under strict plaque control. J Clin Periodontol. 2006; 33(1): 42-48.
  • Harper DS, Robinson PJ. Correlation of histometric, microbial, and clinical indicators of periodontal disease status before and after root planing. J Clin Periodontol. 1987; 14(4): 190-196.
  • Magnusson I, Lindhe J, Yoneyama T, Liljenberg B. Recolonization of a subgingival microbiota following scaling in deep pockets. J Clin Periodontol. 1984; 11(3): 193-207.
  • Quirynen M, Teughels W, De Soete M, van Steenberghe D. Topical antiseptics and antibiotics in the initial therapy of chronic adult periodontitis: microbiological aspects. Periodontol 2000. 2002; 28: 72-90.
  • Herrera D, Sanz M, Jepsen S, Needleman I, Roldan S. A systematic review on the effect of systemic antimicrobials as an adjunct to scaling and root planing in periodontitis patients. J Clin Periodontol. 2002; 29 (3): 136-159.
  • Bono A, Brunotto M. Amoxicillin/metronidazole or scaling and root planing in the treatment of chronic periodontitis. Acta Odontol Latinoam. 2010; 23(3): 196-203.
  • Noyan U, Yilmaz S, Kuru B, Kadir T, Acar O, Buget E. A clinical and microbiological evaluation of systemic and local metronidazole delivery in adult periodontitis patients. J Clin Periodontol. 1997; 24(3): 158-165.
  • Hanes PJ, Purvis JP. Local anti-infective therapy: pharmacological agents. A systematic review. Ann Periodontol. 2003; 8(1): 79-98.
  • Teughels W, Van Essche M, Sliepen I, Quirynen M. Probiotics and oral healthcare. Periodontol 2000. 2008; 48: 111-147.
  • FAO/WHO. London, Ontario, Canada:Working group report on drafting guidelines for the evaluation of probiotics in food: 2002; April 30&May 1. Available from: “http://www.who.int/foodsafety”.
  • Carol M, Borruel N, Antolin M, Llopis M, Casellas F, Guarner F, Malagelada JR. Modulation of apoptosis in intestinal lymphocytes by a probiotic bacteria in Crohn’s disease. J Leukoc Biol. 2006; 79(5): 917-922.
  • de Vrese M, Schrezenmeir J. Probiotics, prebiotics, and synbiotics. Adv Biochem Eng Biotechnol. 2008; 111: 1-66.
  • Gueimonde M, Salminen S. New methods for selecting and evaluating probiotics. Dig Liver Dis. 2006; 38 (2): 242-7.
  • Isolauri E, Salminen S, Ouwehand AC. Probiotics. Best Pract Res Clin Gastroenterol. 2004; 18(2): 298-313.
  • Iqbal MZ, Qadir MI, Hussain T, Janbaz KH, Khan YH, Ahmad B. Review: Probiotics and their beneficial effects against various diseases. Pak J Pharm Sci. 2014; 27(2): 405-15.
  • Kragen H. The treatment of inflammatory affections of the oral mucosa with a lactic acid bacterial culture preparation. Zahnarztl Welt. 1954; 9(11): 306-8.
  • Nase L, Hatakka K, Savilahti E, Saxelin M, Ponka A, Poussa T, Korpela R, Meurman JH. Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children. Caries Res. 2001; 35(6): 412-20.
  • Herod EL. The effect of cheese on dental caries: a review of the literature. Aust Dent J. 1991; 36(2): 120-5.
  • Iwamoto T, Suzuki N, Tanabe K, Takeshita T, Hirofuji T. Effects of probiotic Lactobacillus salivarius WB21 on halitosis and oral health: an open-label pilot trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110(2): 201-8.
  • Hatakka K, Ahola AJ, Yli-Knuuttila H, Richardson M, Poussa T, Meurman JH, Korpela R. Probiotics reduce the prevalence of oral candida in the elderly--a randomized controlled trial. J Dent Res. 2007; 86(2): 125-30.
  • Krasse P, Carlsson B, Dahl C, Paulsson A, Nilsson A, Sinkiewicz G. Decreased gum bleeding and reduced gingivitis by the probiotic Lactobacillus reuteri. Swed Dent J. 2006; 30(2): 55-60.
  • Shimauchi H, Mayanagi G, Nakaya S, Minamibuchi M, Ito Y, Yamaki K, Hirata H. Improvement of periodontal condition by probiotics with Lactobacillus salivarius WB21: a randomized, double-blind, placebo- controlled study. J Clin Periodontol. 2008; 35(10): 897-905.
  • Teughels W, Loozen G, Quirynen M. Do probiotics offer opportunities to manipulate the periodontal oral microbiota? J Clin Periodontol.
  • Teughels W, Newman MG, Coucke W, Haffajee AD, Van Der Mei HC, Haake SK, Schepers E, Cassiman JJ, Van Eldere J, van Steenberghe D, Quirynen M. Guiding periodontal pocket recolonization: a proof of concept. J Dent Res. 2007; 86(11): 1078-82.
  • Riccia DN, Bizzini F, Perilli MG, Polimeni A, Trinchieri V, Amicosante G, Cifone MG. Anti-inflammatory effects of Lactobacillus brevis (CD2) on periodontal disease. Oral Dis. 2007; 13(4): 376-85.
  • Twetman S, Derawi B, Keller M, Ekstrand K, Yucel-Lindberg T, Stecksen- Blicks C. Short-term effect of chewing gums containing probiotic Lactobacillus reuteri on the levels of inflammatory mediators in gingival crevicular fluid. Acta Odontol Scand. 2009; 67(1): 19-24.
  • Harini PM, Anegundi RT. Efficacy of a probiotic and chlorhexidine mouth rinses: a short-term clinical study. J Indian Soc Pedod Prev Dent. 2010; 28(3): 179-82.
  • Vicario M, Santos A, Violant D, Nart J, Giner L. Clinical changes in periodontal subjects with the probiotic Lactobacillus reuteri Prodentis: a preliminary randomized clinical trial. Acta Odontol Scand. 2013; 71(3-4): 813-9.
  • Kang MS, Chung J, Kim SM, Yang KH, Oh JS. Effect of Weissella cibaria isolates on the formation of Streptococcus mutans biofilm. Caries Res. 2006; 40(5): 418-25.
  • Ishikawa H, Aiba Y, Nakanishi M, Yoshitami O-H, Koga Y. Suppression of periodontal pathogenic bacteria in the saliva of humans by the administration of Lactobacillus salivarius TI 2711. J Jpn Soc Periodontol. 2003; 45(1): 105-12.
  • Koll-Klais P, Mandar R, Leibur E, Marcotte H, Hammarstrom L, Mikelsaar M. Oral lactobacilli in chronic periodontitis and periodontal health: species composition and antimicrobial activity. Oral Microbiol Immunol. 2005; 20(6): 354-61.
  • Stamatova I, Kari K, J.H. M. In vitro evaluation of antimicrobial activity of putative probiotic lactobacilli against oral pathogens. Int J Probiotics Prebiotics. 2008; 2: 225-32.
  • Zahradnik RT, Magnusson I, Walker C, McDonell E, Hillman CH, Hillman JD. Preliminary assessment of safety and effectiveness in humans of ProBiora3, a probiotic mouthwash. J Appl Microbiol. 2009; 107(2): 682-90.
  • Zhu Y, Xiao L, Shen D, Hao Y. Competition between yogurt probiotics and periodontal pathogens in vitro. Acta Odontol Scand. 2010; 68(5): 261-8.
  • Hojo K, Nagaoka S, Murata S, Taketomo N, Ohshima T, Maeda N. Reduction of vitamin K concentration by salivary Bifidobacterium strains and their possible nutritional competition with Porphyromonas gingivalis. J Appl Microbiol. 2007; 103(5): 1969-74.
  • Kinane DF. Causation and pathogenesis of periodontal disease. Periodontol 2000. 2001; 25: 8-20.
  • Lindhe J, Hamp S, Loe H. Experimental periodontitis in the beagle dog. J Periodontal Res. 1973; 8(1): 1-10.
  • Listgarten MA, Schifter CC, Laster L. 3-year longitudinal study of the periodontal status of an adult population with gingivitis. J Clin
  • Loe H, Anerud A, Boysen H, Morrison E. Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri Lankan laborers 14 to 46 years of age. J Clin Periodontol. 1986; 13(5): 431-45.
  • Miyasaki KT, Nisengard RJ, Haake SK. Immunitiy and Inflammation: Basic Concepts. In: Newman M, Takei H, Carranza F, eds. Clinical Periodontology. 9th ed. China: WB Saunders Co; 2002. p. 113-31.
  • Page RC, Offenbacher S, Schroeder HE, Seymour GJ, Kornman KS. Advances in the pathogenesis of periodontitis: summary of developments, clinical implications and future directions. Periodontol 2000. 1997; 14: 216-48.
  • Socransky SS, Haffajee AD. Evidence of bacterial etiology: a historical perspective. Periodontol 2000. 1994; 5: 7-25.
  • Darby IB, Mooney J, Kinane DF. Changes in subgingival microflora and humoral immune response following periodontal therapy. J Clin Periodontol. 2001; 28(8): 796-805.
  • Kremer BH, Loos BG, van der Velden U, van Winkelhoff AJ, Craandijk J, Bulthuis HM, Hutter J, Varoufaki AS, van Steenbergen TJ. Peptostreptococcus micros smooth and rough genotypes in periodontitis and gingivitis. J Periodontol. 2000; 71(2): 209-18.
  • Lai CH, Listgarten MA, Shirakawa M, Slots J. Bacteroides forsythus in adult gingivitis and periodontitis. Oral Microbiol Immunol. 1987; 2(4):
  • Loesche WJ. Importance of nutrition in gingival crevice microbial ecology. Periodontics. 1968; 6(6): 245-9.
  • Moore WE, Moore LV. The bacteria of periodontal diseases. Periodontol 2000. 1994; 5: 66-77.
  • Slots J. Subgingival microflora and periodontal disease. J Clin Periodontol. 1979; 6(5): 351-82.
  • Socransky SS, Haffajee AD. Microbial mechanisms in the pathogenesis of destructive periodontal diseases: a critical assessment. J Periodontal Res. 1991; 26(3 Pt 2): 195-212.
  • Socransky SS, Haffajee AD. The bacterial etiology of destructive periodontal disease: current concepts. J Periodontol. 1992; 63(4): 322- 31.
  • Tanner AC, Haffer C, Bratthall GT, Visconti RA, Socransky SS. A study of the bacteria associated with advancing periodontitis in man. J Clin Periodontol. 1979; 6(5): 278-307.
  • Caffesse RG, Mota LF, Morrison EC. The rationale for periodontal therapy. Periodontol 2000. 1995; 9: 7-13.
  • Umeda M, Takeuchi Y, Noguchi K, Huang Y, Koshy G, Ishikawa I. Effects of nonsurgical periodontal therapy on the microbiota. Periodontol 2000. 2004; 36: 98-120.
  • Cobb CM. Non-surgical pocket therapy: mechanical. Ann Periodontol. 1996; 1(1): 443-90.
  • Lavanchy DL, Bickel M, Baehni PC. The effect of plaque control after scaling and root planing on the subgingival microflora in human periodontitis. J Clin Periodontol. 1987; 14(5): 295-9.
  • Mousques T, Listgarten MA, Stoller NH. Effect of sampling on the composition of the human subgingival microbial flora. J Periodontal Res. 1980; 15(2): 137-43.
  • Tanner AC, Goodson JM. Sampling of microorganisms associated with periodontal disease. Oral Microbiol Immunol. 1986; 1(1): 15-22.
  • Slots J, Mashimo P, Levine MJ, Genco RJ. Periodontal therapy in humans. I. Microbiological and clinical effects of a single course of periodontal scaling and root planing, and of adjunctive tetracycline therapy. J Periodontol. 1979; 50(10): 495-509.
  • Sherman PR, Hutchens LH, Jewson LG, Moriarty JM, Greco GW, McFall WT. The effectiveness of subgingival scaling and root planning. I. Clinical detection of residual calculus. J Periodontol. 1990; 61(1): 3-8.
  • Hammerle CH, Joss A, Lang NP. Short-term effects of initial periodontal therapy (hygienic phase). J Clin Periodontol. 1991; 18(4): 233-9.
  • Doungudomdacha S, Rawlinson A, Walsh TF, Douglas CW. Effect of non-surgical periodontal treatment on clinical parameters and the numbers of Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actinomycetemcomitans at adult periodontitis sites. J Clin Periodontol. 2001; 28(5): 437-45.
  • Yilmaz S, Kuru B, Kuru L, Noyan U, Argun D, Kadir T. Effect of gallium arsenide diode laser on human periodontal disease: a microbiological and clinical study. Lasers Surg Med. 2002; 30(1): 60-6.
  • Yilmaz S, Algan S, Gursoy H, Noyan U, Kuru BE, Kadir T. Evaluation of the clinical and antimicrobial effects of the Er:YAG laser or topical gaseous ozone as adjuncts to initial periodontal therapy. Photomed Laser Surg. 2013; 31(6): 293-8.
  • Haffajee AD, Cugini MA, Dibart S, Smith C, Kent RL, Socransky SS. The effect of SRP on the clinical and microbiological parameters of periodontal diseases. J Clin Periodontol. 1997; 24(5): 324-34.
  • Takamatsu N, Yano K, He T, Umeda M, Ishikawa I. Effect of initial periodontal therapy on the frequency of detecting Bacteroides forsythus, Porphyromonas gingivalis, and Actinobacillus actinomycetemcomitans. J Periodontol. 1999; 70(6): 574-80.
  • Ali RW, Lie T, Skaug N. Early effects of periodontal therapy on the detection frequency of four putative periodontal pathogens in adults. J Periodontol. 1992; 63(6): 540-7.
  • Chaves ES, Jeffcoat MK, Ryerson CC, Snyder B. Persistent bacterial colonization of Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans in periodontitis and its association with alveolar bone loss after 6 months of therapy. J Clin Periodontol. 2000; 27(12): 897-903.
  • Christersson LA, Slots J, Rosling BG, Genco RJ. Microbiological and clinical effects of surgical treatment of localized juvenile periodontitis. J Clin Periodontol. 1985; 12(6): 465-76.
  • Gmur R, Strub JR, Guggenheim B. Prevalence of Bacteroides forsythus and Bacteroides gingivalis in subgingival plaque of prosthodontically treated patients on short recall. J Periodontal Res. 1989; 24(2): 113-20.
  • Haffajee AD, Cugini MA, Dibart S, Smith C, Kent RL, Socransky SS. Clinical and microbiological features of subjects with adult periodontitis who responded poorly to scaling and root planing. J Clin Periodontol. 1997; 24(10): 767-76.
  • Mombelli A, Gmur R, Gobbi C, Lang NP. Actinobacillus actinomycetemcomitans in adult periodontitis. II. Characterization of isolated strains and effect of mechanical periodontal treatment. J
  • Nieminen A, Siren E, Wolf J, Asikainen S. Prognostic criteria for the efficiency of non-surgical periodontal therapy in advanced periodontitis. J Clin Periodontol. 1995; 22(2): 153-61.
  • Rams TE, Listgarten MA, Slots J. Utility of 5 major putative periodontal pathogens and selected clinical parameters to predict periodontal breakdown in patients on maintenance care. J Clin Periodontol. 1996; 23(4): 346-54.
  • Renvert S, Wikstrom M, Dahlen G, Slots J, Egelberg J. On the inability of root debridement and periodontal surgery to eliminate Actinobacillus actinomycetemcomitans from periodontal pockets. J Clin Periodontol. 1990; 17(6): 351-5.
  • Sbordone L, Ramaglia L, Gulletta E, Iacono V. Recolonization of the subgingival microflora after scaling and root planing in human periodontitis. J Periodontol. 1990; 61(9): 579-84.
  • Shiloah J, Patters MR. Repopulation of periodontal pockets by microbial pathogens in the absence of supportive therapy. J Periodontol. 1996; 67(2): 130-9.
  • Asikainen S, Alaluusua S, Saxen L. Recovery of A. actinomycetemcomitans from teeth, tongue, and saliva. J Periodontol. 1991; 62(3): 203-6.
  • Van der Velden U, Van Winkelhoff AJ, Abbas F, De Graaff J. The habitat of periodontopathic micro-organisms. J Clin Periodontol. 1986; 13(3):
  • Van Winkelhoff AJ, Van der Velden U, Clement M, De Graaff J. Intra-oral distribution of black-pigmented Bacteroides species in periodontitis patients. Oral Microbiol Immunol. 1988; 3(2): 83-5.
  • Haffajee AD, Socransky SS, Gunsolley JC. Systemic anti-infective periodontal therapy. A systematic review. Ann Periodontol. 2003; 8(1): 115-81.
  • Plinius Secundus Maior G. Naturalis Historiae (77 ad). 28: 36-135.
  • Pasteur L, Joubert JF. Charbon et septicemie. CR Soc Biol Paris 1877; 85: 101-15.
  • Metchnikoff E. Lactic acid as inhibiting intestinal putrefactions. In: Metchnikoff E, Mitchell PC, eds. The prolongation of life; optimistic studiesed. London: Heinemann W; 1907. p. 161-83.
  • Vasiljevic T, Shah NP. Probiotics - From Metchnikoff to bioactives. Int Dairy J. 2008; 18: 714-28.
  • Salminen S, Deighton MA, Benno Y, Gorbach SL. Lactic acid bacteria in health and disease. In: Salminen S, von Wright A, eds. Lactic acid bacteria: microbiology and functional aspects. 2nd ed. New York: Marcel Dekker Inc; 1998. p. 211-54.
  • Borchers AT, Selmi C, Meyers FJ, Keen CL, Gershwin ME. Probiotics and immunity. J Gastroenterol. 2009; 44(1): 26-46.
  • Lee KY, Salminen, S. The coming of age of probiotics. Trends Food Sci Tech. 1995; 6(7): 241-45.
  • Gupta V, Garg R. Probiotics. Indian J Med Microbiol. 2009; 27(3): 202- 9.
  • Ouwehand AC, Kirjavainen PV, Shortt C, Salminen S. Probiotics: mechanisms and established effects. Int Dairy J. 1999; 9(1): 43-52.
  • Salminen S, Ouwehand A, Benno Y, Lee YK. Probiotics: how should they be defined? Trends Food Sci Tech. 1999; 10(3): 107-10.
  • Fuller R. Probiotics in human medicine. Gut. 1991; 32(4): 439-42.
  • Gionchetti P, Rizzello F, Lammers KM, Morselli C, Sollazzi L, Davies S, Tambasco R, Calabrese C, Campieri M. Antibiotics and probiotics in treatment of inflammatory bowel disease. World J Gastroenterol. 2006; 12(21): 3306-13.
  • Fooks LJ, Fuller R, Gibson GR. Prebiotics, probiotics and human gut microbiology. Int Dairy J. 1999; 9: 53-61.
  • Shanahan F. A commentary on the safety of probiotics. Gastroenterol Clin North Am. 2012; 41(4): 869-76.
  • Stamatova I, Meurman JH. Probiotics: health benefits in the mouth. Am J Dent. 2009; 22(6): 329-38.
  • Stamatova I, Meurman JH. Probiotics and periodontal disease. Periodontol 2000. 2009; 51: 141-51.
  • Vivekananda MR, Vandana KL, Bhat KG. Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: a preliminary randomized clinical trial. J Oral Microbiol. 2010; 2.
  • Teughels W, Durukan A, Ozcelik O, Pauwels M, Quirynen M, Haytac MC. Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study. J Clin Periodontol. 2013; 40(11): 1025-35.
  • Matsuoka T, Sugano N, Takigawa S, Takane M, Yoshimura N, Ito K, Koga Y. Effect of oral Lactobacillus salivarius TI 2711 (LS 1) administration on periodontopathic bacteria in subgingival plaque. J Jpn Assoc Periodontol. 2006; 48(4): 315-24.
  • Mayanagi G, Kimura M, Nakaya S, Hirata H, Sakamoto M, Benno Y, Shimauchi H. Probiotic effects of orally administered Lactobacillus salivarius WB21-containing tablets on periodontopathic bacteria: a double-blinded, placebo-controlled, randomized clinical trial. J Clin Periodontol. 2009; 36(6): 506-13.
  • Iniesta M, Herrera D, Montero E, Zurbriggen M, Matos AR, Marin MJ, Sanchez-Beltran MC, Llama-Palacio A, Sanz M. Probiotic effects of orally administered Lactobacillus reuteri-containing tablets on the subgingival and salivary microbiota in patients with gingivitis. A randomized clinical trial. J Clin Periodontol. 2012; 39(8): 736-44.
  • Hallstrom H, Lindgren S, Yucel-Lindberg T, Dahlen G, Renvert S, Twetman S. Effect of probiotic lozenges on inflammatory reactions and oral biofilm during experimental gingivitis. Acta Odontol Scand. 2013; 71(3-4): 828-33.
  • Grudianov AI, Dmitrieva NA, Fomenko EV. Use of probiotics Bifidumbacterin and Acilact in tablets in therapy of periodontal inflammations. Stomatologiia (Mosk). 2002; 81(1): 39-43.
  • Volozhin AI, Il’in VK, Maksimovskii Iu M, Sidorenko AB, Istranov LP, Tsarev VN, Istranova EV, Aboiants RK. Development and use of periodontal dressing of collagen and Lactobacillus casei 37 cell suspension in combined treatment of periodontal disease of inflammatory origin (a microbiological study). Stomatologiia (Mosk). 2004; 83(6): 6-8.
  • Slawik S, Staufenbiel I, Schilke R, Nicksch S, Weinspach K, Stiesch M, Eberhard J. Probiotics affect the clinical inflammatory parameters of experimental gingivitis in humans. Eur J Clin Nutr. 2011; 65(7): 857- 63.
  • Staab B, Eick S, Knofler G, Jentsch H. The influence of a probiotic milk drink on the development of gingivitis: a pilot study. J Clin Periodontol. 2009; 36(10): 850-6.
  • Berglundh T, Krok L, Liljenberg B, Westfelt E, Serino G, Lindhe J. The use of metronidazole and amoxicillin in the treatment of advanced periodontal disease. A prospective, controlled clinical trial. J Clin Periodontol. 1998; 25(5): 354-62.